Bashful Bladder Not So Shy after Brief CBT. (Afflicts about 7% of Population)

Walsh, Nancy, Clinical Psychiatry News

PHILADELPHIA -- Bashful bladder is no laughing matter.

Some 7% of the population is afflicted with avoidant paruresis, a form of social phobia that involves difficulty urinating in public places, Steven Soifer, Ph.D., said in a poster presentation at the annual meeting of the American Psychiatric Association.

Patients with bashful bladder typically are unable to void anywhere but at home and in private, which can adversely affect occupational options and can limit many aspects of life. "These patients never date or travel," Dr. Soifer told this newspaper.

But the good news is that a brief program of cognitive-behavioral therapy (CBT) using graduated exposures can set these patients on a road to psychological relief and some degree of symptom alleviation, he commented.

In a study of 101 patients with the condition, severity self-ratings averaged 7 out of 10 before the workshop. After the program and at 1-year follow-up, the average score was six, which was a statistically significant difference.

The program involves a weekend concentrated group workshop in which patients undergo repetitive exposure to progressively more challenging restroom situations. Initially patients share their stories. "There is an enormous sense of relief being with other people who have the problem and to be able to talk about it, often for the first time," said Dr. Soifer of the School of Social Work, University of Maryland, Baltimore.

The practice sessions begin with patients attempting to urinate in their hotel bathrooms with another person present in the hotel room. …

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